Context The incidence of breast cancer disease is on the rise in Nigeria. There is an urgent need for adequate knowledge regarding the disease among the risky populations for necessary self-care practices as an intervention measure.Aim The main purpose of this study was to assess the knowledge, attitudes, and practices of women concerning breast cancer in Kaduna Metropolis of Kaduna State.Settings and design It was a cross-sectional study conducted in Kaduna Metropolis.Materials and methods Semistructured questionnaires were administered to 300 respondents who consisted of women within the ages of 18 years and older and residing in Kaduna Metropolis.Statistical analysis The collected data were analyzed using the IBM statistical package for social sciences, version 20.0 software programmer.Results Although the results showed that most of the respondents (93%) were aware of breast cancer through different sources of information, their average knowledge scores on risk factors (30.36), signs, and symptoms (48.7%) were below average; however, their knowledge on the different screening methods was slightly above average (53.8%).Conclusion The result showed respondents’ high levels of awareness on breast cancer but poor knowledge on the risk factors, signs and symptoms, and screening practices despite their positive attitudes toward the disease.

Epidemiologic studies have shown high burden of breast cancer in both the developed and developing countries, and the cases were seen to be on the rise [1],[2]. It had been reported to be associated with poor knowledge of the public regarding the disease and its risk factors, in addition to their attitudes and practices toward the screening and preventive practices [3],[4]. Some of the common predisposing risk factors that have been reported to influence the prevalence of the disease include diet and diet-related factors, alcohol and tobacco consumption, hormones and reproductive factors, exposure to ionizing radiation, family history of breast cancer, and presence of benign breast disease [5],[6],[7].

To reduce the incidence of the disease, there was a need for understanding the respondents’ skill and knowledge regarding the importance of paying close attention to lifestyles or related factors that might expose them to the disease, in addition to their screening practices toward ensuring prevention [8],[9],[10],[11].

Several studies had documented different levels of the knowledge, attitude, and practice of women regarding breast cancer from different parts of the world [12],[13],[14], with some from Nigeria [15],[16],[17]. In the course of our literature search, it was observed that not much information relating to patients’ knowledge and practices on breast cancer was available in the Kaduna State; hence, the purpose of the study was to assess women’s understanding and practices related to breast cancer. The outcome of the study will help in strengthening the preventive components of breast cancer control strategy in the state and by extension, Nigeria.

Materials and methods

Study location

The study was carried out in three local government areas of Kaduna State (Kaduna South, Kaduna North, and Lere). Kaduna State is located in northwestern zone of Nigeria, sharing boundaries with Niger State to the west; Zamfara, Katsina, and Kano states to the north; Bauchi and Plateau states to the east; and Abuja and Nasarawa states to the south [18].

Study population and sample size

The study population consisted of all women within the age limits of 18 years and older residing within the study areas. The sample size was calculated using Slovin formula at confidence interval of 95%, with absolute precision of 0.05 [19].

Study design

The respondents were purposely selected based on strategic locations and population sizes, and at each of the selected location, simple random sampling was used in selecting the 300 respondents.

Ethical approval

The study was approved by the Ethics Committee of the Faculty of Pharmaceutical Sciences, University of Jos, Nigeria. The purpose of the study was explained to all the respondents, and their verbal consents were obtained. They were also assured of confidentiality of the collected information, in addition to informing them that participation in the study was voluntary.

Data collection

A semistructured questionnaire covering all the relevant information pertaining to the study variables such as sociodemographic information, knowledge, attitude, and practice of the respondent was included. It was developed based on questions used in previous peer-reviewed published studies, and the instrument was pretested on seven respondents within the study areas, and the results were excluded from the main report of the study.

The pretested questionnaires were then self-administered to the respondents within the study areas, with special guidance given to those who were not sufficiently literate. Thereafter, the filled questionnaires were retrieved on the spot by the researcher and coded for analysis.

Data analysis

The collected data were then encoded and analyzed using IBM statistical package for social sciences, version 20, to statistically describe the frequencies of occurrences of the study variables among respondents (SPSS; SPSS Inc., Chicago, Illinois, USA).

Results

Respondents’ demographic characteristics

Of the 300 (100%) respondents who participated in the study, 55.30% of them were within the age brackets of 18 and 27 years, with 26.7% being in the age bracket of 28 and 37 years; most of them (58.3%) were single, whereas 34.7% were married. Most of them (30.3%) had degree as their highest academic qualification followed by diploma/NCE/CHEW (28%) and secondary certificates (27.7%) ([Table 1]).

Most of the respondents (93%) had heard of breast cancer through different sources of information, with most of them identifying health workers and the media as their main sources of information ([Figure 1] and [Figure 2]).

[Table 2] shows that the respondents’ knowledge on some of the predisposing risk factors of the disease such as positive family history (60.7%), tobacco consumption (53.7%) and smoking (52.7%) was fair, but their average knowledge score on all the selected risk factors was poor (30.36%).

Their knowledge regarding the signs and symptoms of breast cancer was below average (48.71%), though the details of the results ([Table 2]) showed their good recognitions of some of the symptoms such as presence of lumps in the breast (81.30%), pain or soreness in the breast (71%), swelling or enlargement of the breast (65%), discharge from the breast (57%), and changes in the shape of the breast (50%).

Approximately half of the respondents (53.80%) were able to identify the different screening methods for the disease, with most of them (72.7%) recognizing self-breast examination as the best screening method ([Table 2]).

Respondents’ attitudes toward breast cancer

Most of the respondents admitted that breast cancer was more prevalent in Nigeria, with more than 70% of them agreeing that any woman could be at risk of getting the disease. Similarly, most of them recognized screening practices as the best approach toward helping in the prevention or early diagnosis and treatment (65.3%) of the disease, with majority of them agreeing with surgical operation as the best treatment option ([Table 3]).

Despite the fact that most of the respondents had good attitudes toward the disease ([Table 3]) and knew the right age for initiating self-breast examination ([Table 4]), their practice of self-breast examination was averagely poor ([Table 4]); more than 60% of them also confessed not visiting a medical practitioner for breast cancer examination and care ([Table 4]).

Although the result of the study showed high levels of awareness about breast cancer among the respondents, their mean score knowledge regarding the risk factors for the disease was poor (30.94%) compared with the results of similar studies conducted by Akhigbe and Omuemu [5] who found the respondents’ knowledge on breast cancer risk factors to be approximately 55%. On the contrary, the findings of the present study showed better knowledge of the study population on risk factors compare with a similar study conducted among women in Northern Nigeria [3].

Regarding the signs and symptoms of the disease, their understandings were averagely fair compared with the risk factors. The observed high knowledge of the respondents on some of the specific symptoms of the disease could be associated with the advancing stages of the disease, which are obvious. For instance, many of them knew that presence of lumps in the breast, pain or soreness in the breast, swelling or enlargement of the breast, discharge from the breast, and changes in the shape of the breast were symptoms of the disease, and these had been reported as indications of later stage of the disease [6],[20],[21].

The observation of poor breast cancer screening practices among respondents was similar to that found in a study conducted by Okobia et al.[16] but was contrary to similar studies conducted in developed countries, which showed the presence of regular self-breast screening practices among women and regular visitations to health personnel for checkup [22],[23],[24],[25]. This may be helpful in early detection and prompt attention to any incidence of the disease, thereby arresting the situation at an earlier stage of the disease [23].Although there was a high level of awareness about the disease among respondents through health personnel, news media, and family members ([Figure 1] and [Figure 2]), their effect on the respondents’ knowledge of the cause and prevention of the disease was minimal. It implies a need for more public teachings about the disease, using the identified common means of information dissemination (e.g., media), as most of the households have televisions or radio. In addition, community health talk on the disease could be organized, during which the disease-related information and its preventive measures could be passed on to the society [26].

Conclusion

The result of this study showed a high level of awareness about the existence of breast cancer disease among the respondents, who also had positive attitudes toward the disease, but their knowledge regarding the disease and the screening practices was poor, which may affect the preventive practices of the disease.

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